目的：观察中药杞精明目汤联合人工泪液对结膜松弛症(CCH)的临床疗效及细胞衰老的影响。

方法：收集40例80眼Ⅱ～Ⅳ级肝肾阴虚型CCH患者，随机分为联合治疗组(杞精明目汤联合人工泪液治疗)和人工泪液组(单纯人工泪液治疗)，观察国际眼表疾病指数(OSDI)、泪膜破裂时间(BUT)、基础泪液分泌试验(SⅠt)，治疗3mo后比较临床治疗效果。对于CCH分级在Ⅲ级及以上，随访3mo及以上并有手术意愿的CCH患者切除松弛结膜组织，冰冻切片行细胞衰老相关的β-gal染色观察，结果行统计学分析。

结果：治疗3mo后联合治疗组的OSDI评分(14.53±2.68分)、BUT(9.25±3.02s)、SⅠt(8.95±3.57mm/5min)均显著优于人工泪液组(P<0.05)。药物治疗后采取手术治疗的CCH患者人工泪液组为7例7眼，联合治疗组为4例4眼，且联合治疗组衰老阳性细胞计数显著低于人工泪液组(16.00±7.84个 vs 39.00±14.09个，P=0.013)。

结论：杞精明目汤联合人工泪液治疗CCH在缓解眼部症状、改善泪膜、促进泪液分泌方面，较单纯人工泪液治疗更为有效。联合治疗还可以减少CCH的细胞衰老，可作为除手术治疗之外安全、有效的治疗方案。

METHODS: Forty cases(80 eyes)of grade II-Ⅳ CCH with liver-kidney Yin deficiency were randomly divided into two groups: combined treatment group and artificial tears group, which were treated with Qi Jing Mingmu decoction combined with artificial tears and simple artificial tears respectively. The international ocular surface disease index(OSDI), tear break-up time(BUT)and Schirmer Ⅰ test(SⅠt)were observed and the clinical effects were compared after 3mo treatment. For CCH patients with grade III or above, followed up for 3mo or more and willing to operate, the loose conjunctival tissue was removed and the cell aging related β-gal staining was performed on frozen sections. The results were statistically analyzed.

RESULTS: The OSDI score(14.53±2.68), BUT 9.25±3.02s and SⅠt(8.95±3.57mm/5min)of combined treatment group were significantly better than those of artificial tears group after 3mo treatment(all P<0.05). After drug treatment, 7 cases(7 eyes)in artificial tears group and 4 cases(4 eyes)in combined treatment group of CCH patients were treated by operation. The positive rate of aging cells in combined treatment group was significantly lower than that in artificial tears group(16.00±7.84 vs 39.00±14.09, P=0.013).

CONCLUSION: Qi Jing Mingmu decoction combined with artificial tears to treat CCH is more effective than simple artificial tears in relieving ocular symptoms, improving tear film and promoting tear secretion. Combined treatment can also reduce the cell aging in CCH, which can be used as a safe and effective treatment method in addition to surgical operation.